Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intravenous regional anaesthesia.Methods: In prospective, randomized study, sixty patient ASA physical status I, aged 20-50years underwent surgeries on distal regions of upper limbs, patient assigned randomly into 3 groups each of 20 patients, group I received 30ml of 0.5% lidocaine (150mg), group II received 30ml of mixing 0.5% of lidocaine (100mg) plus 30mg ketamine, while group III received 30ml of mixing 0.5% lidocaine (100mg) plus 30mg ketamine plus 2mg atracurium. All the results were tabulated and analyzed statistically with student's unpaired t-test and chi-square test. Results: Addition of 30mg of ketamine to 0.5% lidocaine resulted in rapid onset of sensory block, motor block, and lower visual analogue scale scores for pain compared with the group that received lidocaine only. The addition of atracurium to the combination of lidocaine and ketamine resulted in improved operating conditions and rapid onset of both sensory and motor blocks with less pain during surgery.Conclusions: drug combination of ketamine, atracurium and low dose of lidocaine lead to rapid onset of sensory block, motor block, lower VAS score for pain, and decrease adverse effect of Bier’s block accompany lidocaine alone, decrease drowsiness which accompany ketamine use alone in IVRA
While many educators are highly focused on state test, it is important to consider that
over the course of a year, instructors can build in many opportunities to assess how learners
are learning. Therefore, assessment techniques are considered a good method to get benefit
for both instructors and learners in the process of teaching and learning. The sample consists
of 27 learners who participated in TOEFL training course in the Development and Continuous
Education Centre. Validity and reliability were verified.
To fulfill the aims and verify the hypothesis which reads as follows” It is hypothesized
that the TOEFL learners' scores will not be increased after TOEFL course training.” T-test
for two dependent samp
Planning of cities show great attention on streets planning as one of the most structural component foundations for cities, that providing many functional needs and connect parts of the city each other, and work as a commercial and services activities centers. Instead of this highly focused on distributing streets with different streets types such as economical and trading and housing streets. This concerned was only on the dimensions and scales of different types of vehicles and their movement. When scale and dimension and movement of mans were as a second priority in designing and planning streets. Which came's first for traditional streets. The research try to submit some designs guides for planners that contribute in re conce
... Show MoreThis research focused on clarifying the relationship strategic decisions for operations management & performance excellence organizational, The research emerges from a problem which explained by many application questions. Special questionnaire has been prepared for this purpose distributed (72) to sample of management levels (Top, middle) in the General company for mining industries and aquatic Insullation & the General company of batteries industry, The research has tried to test a number hypotheses related to the relation and regression among the variables of the research, and the differences among the <
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The present study aims at knowing the effect of discussion method for students of fifth grade in preparatory school.
Methodology of the Study:
In order to achieve the objective of the study, the researcher chooses non-randomly the preparatory school affiliated to the District Chamchamal \ Suliemnaniya. The sample attained 64 students in 32 per group (control and experimental) groups. The researcher used the discussion method which was applied on experimental group. She uses the traditional method on the control group.
The researcher matched the two group in ago, intelligence, marks at the Kurdish Language in the previous year , pretest and posts for the indepe
... Show MoreIn this work an approach has been developed to investigate the influence of surface roughness on thermohydrodynamic performance in aligned and misaligned journal bearings by considering an average flow model and deriving the shear flow factor for various roughness configurations, similar to the pressure flow factor. An average Reynolds equation for rough surfaces is defined in term of pressure and shear flow factors, which can be obtained by numerical flow simulation, though the use of measured or numerically generated rough surfaces. Reynolds, heat conduction and energy equations are solved simultaneously by using a suitable numerical technique (Finite Difference Method) to obtain the pressure and temperature di
... Show MoreAbstract:
This research aims to identify the impact of the Layout Ghazi al-Hariri hospital for surgery specialist on customer satisfaction (patients) using the model (Servicescape), the problem of the research represented in the extent to which the hospital management design of the service and Layout hospital aesthetic and functional aspects that fit patients for therapeutic and nursing services , and used the developer scale by (Miles et al., 2012) for data collection, which includes the independent variable in (17) items distributed in three dimensions (Facility aesthetics , hospital cleanliness, and the Layout accessibility ) The dependent variable is the satisfaction of customers (pat
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The study seeks to investigate the effect of Dunn Dunn learning style model on students’ achievement. Besides, the way of developing students’ deductive thinking by testing the null hypothesis: there is no significant difference between experimental group who takes Dunn Dunn model as style in studying geography and control group that follows a traditional method in studying geography at the level of (0,05). Additionally, there is no significant difference between experimental group who takes Dunn Dunn model as style in studying geography and control group that follows a traditional method in studying geography at the level of (0,05) on testing developing deductive thinking skills. The researcher adopted a quasi-experimental posttest
... Show MoreThis study produces an image of theoretical and experimental case of high loading stumbling condition for hip prosthesis. Model had been studied namely Charnley. This model was modeled with finite element method by using ANSYS software, the effect of changing the design parameters (head diameter, neck length, neck ratio, stem length) on Charnley design, for stumbling case as impact load where the load reach to (8.7* body weight) for impact duration of 0.005sec.An experimental rig had been constructed to test the hip model, this rig consist of a wood box with a smooth sliding shaft where a load of 1 pound is dropped from three heights.
The strain produced by this impact is measured by using rosette strain gauge connected to Wheatstone
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